胞二磷胆碱联合奥拉西坦治疗新生儿缺氧缺血性脑病的临床研究

Clinical study on citicoline combined with oxiracetam in treatment of neonatal hypoxic ischemic encephalopathy

目的研究胞二磷胆碱联合奥拉西坦治疗新生儿缺氧缺血性脑病的临床疗效。方法选取2016年9月—2018年10月海安市人民医院收治的缺血缺氧性脑病患儿100例纳入此次研究范围,采用数字表法将所有患儿随机分为对照组和治疗组,每组各50例。对照组静脉滴注奥拉西坦注射液,1g加入到5%葡萄糖注射液50m L中,1次/d。治疗组在对照组治疗的基础上静脉滴注胞二磷胆碱注射液,1m L加入到10%葡萄糖注射液30m L中,1次/d。两组患儿均持续治疗2周。观察两组的临床疗效,比较两组的血清学指标、新生儿神经行为(NABA)评分、运动发育指数(PDI)评分和智力发育指数(MDI)评分。结果治疗后,对照组和治疗组的总有效率分别为72.0%、90.0%,两组比较差异有统计学意义(P<0.05)。治疗后,两组患儿血清基质金属蛋白酶-9(MMP-9)和Tau蛋白(Tau)水平均明显降低,脂联素(APN)和胰岛素样生长因子-1(IGF-1)水平均明显增高,同组治疗前后比较差异有统计学意义(P<0.05);且治疗组血清学指标明显优于对照组,两组比较差异有统计学意义(P<0.05)。治疗后,两组患儿NBNA评分显著提高,同组治疗前后比较差异有统计学意义(P<0.05);且治疗组NBNA评分明显高于对照组,两组比较差异有统计学意义(P<0.05)。治疗后90d进行随访,两组患儿PDI评分和MDI评分显著提高,同组治疗前后比较差异有统计学意义(P<0.05);且治疗组PDI评分和MDI评分明显高于对照组,两组比较差异有统计学意义(P<0.05)。结论胞二磷胆碱注射液联合奥拉西坦注射液治疗新生儿缺氧缺血性脑病的疗效确切,可改善血清MMP-9、Tau、APN和IGF-1水平,提升患儿神经行为和智力发育情况,具有一定的临床推广应用价值。

Objective To study the clinical effect of Citicoline Injection combined with Oxiracetam Injection in treatment of neonatal hypoxic ischemic encephalopathy. Methods Newborns(100 cases) with hypoxic ischemic encephalopathy in Haian People’s Hospital from September 2016 to October 2018 were randomly divided into control and treatment groups, and each group had 50 cases. Newborns in the control group were iv administered with Oxiracetam Injection, 1 g added into 5% glucose solution 50 mL, once daily. Newborns in the treatment group were iv administered with Citicoline Injection on the basis of the control group, 1 mL added 10% glucose solution 30 m L, once daily. Newborns in two groups were treated for 2 weeks. After treatment, the clinical efficacies were evaluated, and serological indexes, NBNA scores, PDI scores, and MDI scores in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 72.0% and 90.0%, respectively, and there was difference between two groups(P < 0.05). After treatment, the levels of MMP-9 and Tau in two groups were significantly decreased, but the levels of APN and IGF-1 in two groups were significantly increased, and the difference was statistically significant in the same group(P < 0.05). And the serological indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups(P < 0.05). After treatment, NBNA scores in two groups were significantly increased, and the difference was statistically significant in the same group(P < 0.05). And the NBNA score in the treatment group was significantly higher than that in the control group, with significant difference between two groups(P < 0.05). After treatment, PDI scores and MDI scores in two groups were significantly increased, and the difference was statistically significant in the same group(P < 0.05). And the observational indexes in the treatment group were significantly higher than those in the control group, with significant difference between two groups(P < 0.05). Conclusion Citicoline Injection combined with Oxiracetam Injection has clinical curative effect in treatment of neonatal hypoxic ischemic encephalopathy, can the levels of serum MMP-9, Tau, APN and IGF-1, and enhance the neurobehavioral and intellectual development, which has a certain clinical application value.